Gender, socio-economic status, migration origin and neighbourhood of residence are barriers to HIV testing in the Paris metropolitan area

• Published in: AIDS care 2011-12, Vol.23 (12), p.1609-1618
• Main Authors: Massari, Veronique, Lapostolle, Annabelle, Cadot, Emmanuelle, Parizot, Isabelle, Dray-Spira, Rosemary, Chauvin, Pierre
• Format: Article
• Language: English
• Subjects: Acquired Immune Deficiency Syndrome; Adolescent; Adult; Aged; AIDS; AIDS/HIV; Biological and medical sciences; Church Membership; Cohort Studies; Emigration and Immigration; Ethnicity; Female; France; Gender; Health Knowledge, Attitudes, Practice; HIV; HIV Infections - diagnosis; HIV testing; Human immunodeficiency virus; Human viral diseases; Humans; Immigrants; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Infectious diseases; Male; Males; Mass Screening - utilization; Medical sciences; Men; Metropolitan Areas; Middle Aged; Migration; migration status; neighbourhood status; Neighbourhoods; Parents; Paris; Paris, France; Prevention; Primary care; Residence Characteristics; Risk Factors; Sex; Sex Factors; Social Class; social inequalities; Social inequality; Socioeconomic factors; Testing; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Young Adult
• ISSN: 0954-0121; 1360-0451
• DOI: 10.1080/09540121.2011.579940

In France, numerous HIV patients still discover their HIV status as a result of AIDS-related symptoms. We investigated factors related to the absence of any HIV testing in men and women separately, using the data from the SIRS cohort, which includes 3023 households representative of the Paris metropolitan area in 2005. The failure to use HIV testing services was studied in relation to individual socio-economic and demographic factors as well as some psychosocial characteristics. The effect of the characteristics of the residential neighbourhood was also analysed using multilevel models. In multivariate analysis, the factors associated with no history of HIV testing in women were an age >44 years, the absence of any pregnancy during the previous 15 years, a low education level, unemployment, to have had no or only one steady relationship in one's lifetime, to have a religious affiliation and to live in a poor neighbourhood. In men, factors were age 44 years, to have had no or only one steady relationship during one's lifetime, to have a religious affiliation and to perceive oneself as being at low risk of HIV infection. An association according to the "migration origin" was observed among men: foreigners and French men born to (at least) one foreign parent were more likely not to have been tested than French men born to two French parents. We conclude that gender, social and territorial differences exist in HIV testing among people living in the Paris area. More systematic proposals of HIV test in primary care would be an effective policy to overcome these persistent social stratifications.